Scurvy

Case contributed by Dr Jeremy Jones

Presentation

Severe dietary restriction - only eats weetabix. Unable to walk unsupported. Hip and knee pain.

Patient Data

Age: 5 years
Gender: Male
MRI

Bilateral and symmetrical signal abnormality of all visible metaphyses (including radius and ulna). Marrow edema of ischiopubic synchondrosis and ischium.

Case Discussion

The bilateral symmetrical appearances with the history of severe dietary deficiency would fit with severe hypovitaminosis C (scurvy).

This was confirmed biochemically. He was profoundly vitamin C, vitamin D and vitamin B12 deficient. Plasma vitamin C levels were <1 μmol/L (deficiency: <11.0 μmol/L; high: >250 μmol/L).

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